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Abstract Details

Phenotyping the Chronic Neurological Sequelae of Acute SARS-CoV-2 Infections
Infectious Disease
S18 - COVID-19: From Bedside and Beyond (2:36 PM-2:48 PM)
009

To phenotype the neurological dysfunction in post-acute sequelae SARS-CoV-2 infection.

Neurological complications of SARS-CoV-2 infection can arise acutely but can also emerge and persist weeks and months after acute infection. These symptoms can affect up to 80% of those with post-acute sequelae SARS-CoV-2 infection (PASC). The University of Pennsylvania Neuro-COVID Clinic (PNCC) was established to provide care for patients with PASC and to obtain standardized clinical metrics to better define the neurological complications attributed to PASC.

Retrospective analysis of charts from the first 94 patients seen at the PNCC. Demographics as well as standardized clinical histories were reviewed.  Standardized cognitive testing including the Montreal Cognitive Assessment (MOCA version 8.2), Trails A and B, and digit span (forward and reverse) were performed and analyzed with summary statistics.
Mean age of this patient population was 50 years (range 21 – 75yrs) and 67% were female. 30% of patients were admitted to inpatient care during their acute infection (4% required ICU level care). The average time from acute infection to first visit at the PNCC was 234 days (range: 40 – 509 days). The most frequent primary neurological complaint was brain fog (68%) and 91% of patients endorsed some level of brain fog. Abnormal testing (> 4 missed points) on MOCA testing was measured in 39% of patients. Abnormal testing on Trails B (below the age-adjusted 9th percentile) was measured in 16% of patients.

Neurological manifestations of PASC are common even in non-hospitalized patients and brain fog is a frequent symptom. Discrepancies between subjective experience and standardized cognitive testing suggest a multifactorial cause to brain fog in PASC. Co-occurrence of mood symptoms, poor sleep, and medication side effects may exacerbate more direct effects of COVID-19. The long-term trajectory of neurological symptoms in PASC will be determined with longitudinal follow-up of this patient cohort.
Authors/Disclosures
Matthew Schindler, MD, PhD (Univeristy of Pennsylvania)
PRESENTER 		Dr. Schindler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapuetics. Dr. Schindler has received personal compensation in the range of $5,000-$9,999 for serving as a 好色先生al Presenter with Annenberg Center.
Dennis L. Kolson, MD, PhD (University of Pennsylvania) The institution of Dr. Kolson has received research support from NIH--R01 research grant.
Danielle Sandsmark, MD The institution of Dr. Sandsmark has received research support from NINDS. The institution of Dr. Sandsmark has received research support from BrainBox Solutions Inc. The institution of Dr. Sandsmark has received research support from Department of Defense.
Sara Manning, MD Dr. Manning has received publishing royalties from a publication relating to health care.